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Workers’ Compensation Loss Control

Knowledge of and ability to utilize practices, tools and techniques for investigating and providing recommendations for workers’ compensation risks and loss exposures.

Behavior Statements

Proficiency Level 1 - Basic understanding

Identifies the key elements involved in loss investigation for workers' compensation (WC).

Documents approaches applied in evaluating the reliability of workers' compensation cases.

Clarifies the various types of screening surveys used in workers' compensation.

Describes rules of Occupational Safety and Health Act (OSHA) related to workers' compensation safety.

Proficiency Level 2 - Working experience

Researches trends in loss frequency, severity and common loss by analyzing accident claim types.

Utilizes accident analysis and on-site surveys during an investigation for any compensation discrepancies.

Performs occupational health, ergonomic and industrial hygiene screening surveys.

Follows OSHA and state regulations and record-keeping requirements.

Documents workers' compensation coverage issues and states administrative procedures applicable to customers.

Proficiency Level 3 - Extensive experience

Analyzes causal factors involved in workers' compensation cases; provides recommendations for potential risks.

Develops a systematic method of in-depth identification of loss sources.

Coaches others on how to identify damages that do not pertain to WC (e.g. punitive damages for employer negligence.)

Evaluates the customer's general compliance with Federal and State OSHA standards.

Delivers desktop reviews of simpler workers' compensation reports for underwriting.

Advises on basic machine safeguarding, slip/trip/fall and driver/fleet safety evaluations.

Proficiency Level 4 - Subject matter depth and breadth

Designs training programs for conducting significant loss investigations and preparing documents to benefit other staff members.

Leads evaluations of management system failures and conducts program reviews on the overall reimbursement system.

Consults on conducting hazardous material, confined space entry and process safety management evaluations.

Oversees compliance to Federal/State OSHA standards and recommends monitoring and control strategies.

Leads discussions on desktop reviews of the largest, most complex workers' compensation reports for underwriting.

Establishes overall guidelines in how to perform appellate procedures for workers' compensation cases.

Interview Questions

  • Tell me about any resistance you encountered to your loss control plans.
  • What steps do you take when evaluating a workplace safety violation? Tell me about a violation you have identified and resolved.
  • Tell me about a process/policy change that you implemented that was designed to increase worker safety or decrease incidents. What was the end result of this change?
  • Tell me about your experience in managing worker's compensation claims and losses.
  • How did you interpret workers' compensation, relevant expense and loss reports? How did you determine which facts were important, and which were less so?

Titles with Shared Competencies